1. Field of the Invention
The present invention relates to a method of gastrostomy and an infection preventive cover, or catheter kit and a gastrostomy catheter kit for use with the method.
2. Description of the Background Art
For a percutaneous endoscopic gastrostomy (PEG) enabling enteral feeding to a patient who finds difficulty in swallowing feeds or who cannot swallow, it is sufficient to apply a local anesthesia to the patient and the operation time is favorably short, i.e., about five to about ten minutes, and the patient can be quickly recovered after the operation. In a case where the patient in a good general condition after the operation, she or he may leave the hospital on the same day on which the operation is conducted. The PEG is therefore explosively developed worldwide. In the United States, for example, about 180,000 cases were reported in 1997. In the future, the number of the operations is expectedly increased in the world.
As commonly known, the PEG includes three methods, namely, “pull”, “push”, and “introduce” methods (techniques). Among these methods, the “pull” and “push” methods have been broadly adopted due to simplicity and safeness of the operation. However, these methods are attended with two drawbacks as follows.
The endoscope is required to be twice inserted in the pertinent patient, which leads to a problem of complex operations and pains to patients. There exists a fear of damage to the larynx, the upper pharynx or the esophagus.
The PEG catheter (including a PEG tube and an in-stomach remaining member (dome, etc.) connected to the tube) is infected in the oral cavity, the upper pharynx or the larynx and hence the wounded part of the patient is liable to be infected.
The first drawback above can be sufficiently removed by improving the sedation or anesthesia and by increasing the quality of skill of the endoscopist. However, the second drawback, i.e., the infection of the wound due to the contamination of the PEG tube and the in-stomach remaining member takes place with a high possibility. The literature of Europe and America reported about 35% to about 45% of the infection of wound. When the infection of wound occurs, antibiotics are required to be administered to the patient for a long period of time. This resultantly delays the starting point of the enteral feeding for the patient, and immunity of the patient from diseases is weakened, this may elongate the hospital treatment in some cases. The patient suffers from serious pains and the fee for medical treatment soars. Consequently, not only the patient but also family members of the patient must bear the expense and suffer from mental stress. When the cleaning of the oral cavity, the preoperation disinfection of the upper pharynx, and the preventive administration of antibiotics are completely carried out, the number of bacteria appearing on the PEG tube and the in-stomach remaining member can be decreased. However, this is not the basic countermeasure.
A trial for decreasing the number of bacteria appearing on the PEG tube and the in-stomach remaining member is conducted, in which the PEG tube and the in-stomach remaining member are fed into the stomach through the oral cavity, larynx, upper pharynx all esophagus in a state where they are enclosed with a cover. However it is just a trial but does not reach a level of practical use.